#Ortho
Principles of Fructures

- Impacted fracture: also called a torus or buckle fracture, is a piece of the bone may impact another bone, happen as in Corticocalcaneus junction.
Cortico bone have medullary canal.
Calcaneus bone haven't medullary canal.
Its common in # neck of femor, lower end of radius B/w diaphysia (cortical) & metaphysis (calcaneus) called Colles #.

- Referred pain: its pain feel away from its origin.

- Open reduction: means reduce the # under direct vision.
- closed reduction: means reduce the # without exposure the # size.
- pelvis يمشي معاه CT scan أكثر من ال Xray

- Different b/w lig & tendon????

- Dont say open # by X-ray this is wrong but by clinical examination to Pt.

- in examination say Normal range of motion.
Or restricted range of motion.

- Commonuted #: its # of more than 2 paices of bone of fragments.

- Compound #: its Open#. 😉

- Types of dislocation:
Congenital dislocation
Aquired dislocation :
1A) trumatic //
B) pos , Ant, dislocation
C) Central // (femor تخش داخل ال Pelvis )
2A) paralytic //
B) dislocation as in poliomylitis
3) Pathological dislocation.

- Note/ number bone of hand is 27
& All upper limb 30 bone
Both U.L is 60 bone.
- Number bone of foot 26 & 4 in L.L
So All L.L is 60
Both U.L & L.L is 120 bones.

The knee & leg

- Any Pus in Joint should be drainge before antibiotics.

- في hemoarthrosis دير Aspiration حتشوف بعينك حاجة في العينة نفسها تعرف انه عنده #؟
حتلقى Fatty bubbles
In Femor condyle or tebeal platou or in patella.

- Para patellar gutters = parapatellar sulcus
علق عليه ب Fullness not swalling

- Locking: its sudden inability to complete a certain movement suggest mechanical block.

- Osteoarthritis: degenrative changes in the bone.

Knee:
- 3 Types of condylar #:
A) Supracondylar # .
B) Unicondylar # medial or lateral "Hoffa" #
" Frontal plane".
C) Intercondylar # - T or Y types.

- Buttress plate  يعني تتكى عليها بس في علاج displaced.

Donohugus triad :
MCL,  MM , ACL injury.

- Test for meniscal injury:-
Thessalays test :
Pt standing on affected limb with support & asked to IR & ER lower limb.
Pain S/O injury.

- Osteomylitis emergency! B/c dystruction to joint. (( Topic infection))

Hemiarthroplasty = Excisional of head & neck.

Upper limb

- Long thoracic nerve supply serratus ms.

- whats the typical displacement in lower end of radius " Colles #" ? In distal fragment.!!

- Distal radius have special # complication as carbul tunnel syndrome & tendone ruptures.

- in Calcaneus bone have no delayed or non union but in cortical happen malunion.!

- Inserion of extensor pollices longus tendon in medial border of anatomical snafbox at the base of the distal phalanx of DIP the thumb.

- injuries caused on FOOSH in upper limb?
1) colles#
2) Clavicle#
3) # of scaphoid
4) Lunate dislocation
5) # of both bone forearm
6) elbow dislocation
7) Supracondylar # of humerus
8) # surgical neck of humerus
9) shoulder dislocation

- Causes of tenderness in snuff box ?
1) Scaphoid #.
2) # of styloid process
3) # of base of 1st metacarbal and wrist spur.

- Boxer #: its # of neck of 5th metacarbal bone
لما تلقاها معناها ضرب حد او ضرب ايده على الحيط مش طاح ! 😉عليها.
Rx / according to degree of displacement :
If slightly : conservative.
If high: ORIF.

Kienböck's disease: idiopathic avuscular necrosis of lunate, C/P with pain & Dx confirm by radio & MRI , TTT : with partial or complete fusion of wrist.

Bone tumors

- The M.C benign tumor bone in pediatrics is Osteochondroma.
- M.C malignant tumor bone in pediatrics is Osteosarcoma.
- M.C malignancy bone tumor in metastatic bone is Carcinoma.
- Most common site of Giant cell tumor in distal radius, Proximal tibia, distal femor, epiphysis in hip below head of femor.
- you should be see tumor Grading by microscopic (histopathology).
But Staging by CT scan.
- Multiple myeloma only 1ry malignant in the adult & others is 2ry.
- What are the big 5 lesions can be memic anything in X-ray?
1) Metastatic carcinoma.
2) Cartilaginous tumor.
3) Fibrous dysplasia.
4) Eosinophilic granuloma.
5) Osteomyelitis.

Stages of bone tumor 1A, 1B, 2A, 2B, 3.. the last stage is 3 ( Dont say 4🙂).

- measure radiation by centigray.

إضافات الكلية في الأورثو لمستشفى ابوسليم وم. الطبي ⬆️🔥
ربي يوفقنا ويسهل علينا جميعاً يارب.❤️

"لأنهُ الله؛ لأن رَحمتُه فُوق المَدى، فُوق التَخيل والحُدود، فَالخير قادم أقَرب مَما نَظُن؛ وَأكثر مما نُريد" ❤

اللهّم تولانا برحمتك الواسعة يارب العالمين ❤

حَسْبِيَ اللَّهُ لَا إِلَهَ إِلَّا هُوَ، عَلَيْهِ تَوَكَّلْتُ
وَهُوَ رَبُّ الْعَرْشِ الْعَظِيمِ.

من قالها حين يصبح وحين يمسي ٧مرات
كفاه الله ما أهمه من أمر الدنيا والآخرة.💙

يقول النبي ﷺ:
«مَن أصبحَ منكم آمنًا في سربِهِ، مُعافًى في جسدِهِ، عندَهُ قوتُ يومِهِ، فَكَأنَّما حيزت لَهُ الدُّنيا»

يقول النبي ﷺ: «مَن قالَ حينَ يُصبحُ: اللَّهمَّ ما أصبحَ بي مِن نعمةٍ فمِنكَ وحدَكَ لا شريكَ لكَ لكَ الحمدُ، ولكَ الشُّكرُ فقد أدَّى شُكرَ يَومِه»❤

#Breast ⬇️